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Richard Bradley, RPH
NPI 1649317769 · on the registry since 2007 · sole proprietor
Practice
- Address
- 194 Main St.
State Line, MS 39362 - Phone
- (601) 848-7866
- Fax
- (601) 848-7866
- Organisation at this address
- State Line Drugs
State Line Rx LlcInferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi